Emerging Threat Social Media Communication: Measles

For Family Audiences

How Measles Spreads:

• Measles is one of the most contagious infectious diseases known. The virus can live for up to 2 hours in the air where infected people have coughed or sneezed, or on surfaces they may have touched. 
   
• Measles spreads very quickly, and can keep kids away from friends, fun, and learning for weeks. In fact, one person infected with measles can spread it to 18 others.
• Measles is extremely contagious and can cause serious illness and health complications. Vaccination is the best way to protect yourself, your family and your community. If you think that your child has been exposed to measles, call your pediatrician right away.
• Unvaccinated people, especially children under age 5 years, are at the highest risk for developing severe illness from measles. Nearly 1 out of every 3 children under the age of 5 who catches measles ends up in the hospital. 

Measles & Pregnancy:

• Thinking of becoming pregnant? Talk to your doctor about the measles vaccine. If you are pregnant and not previously vaccinated against measles, you cannot receive the MMR vaccine until after delivery. If you are not vaccinated and exposed to measles, it may cause health problems for you and your unborn baby.
• Babies younger than age 6 months cannot be vaccinated against measles. To help protect your baby in the event of an outbreak:
  • Use good hand hygiene.
  • Limit your baby’s exposure to crowds, other children, and anyone with a cold.
  • Limit exposure to potential infections.
  • Disinfect objects and surfaces in your home regularly.
  • Feed your baby breastmilk (when available). 
• Measles is very contagious, so outbreaks happen quickly. Most of the time, children who get measles are not up to date on recommended vaccines or are not old enough to get the vaccine.
• Measles is highly contagious.  During an outbreak, children who have not received a measles vaccine should be excluded from school. 

How to Recognize Measles Signs and Symptoms: 

• Most recognizable measles symptoms:
  • Very high fever 
  • Red or brownish blotchy rash
• Before the rash appears, children with measles may have cold-like symptoms:
  • Cough
  • Runny nose
  • Fever
  • Red, watery eyes
• The rash usually appears 3 to 5 days after the first symptoms, [typically] starting on the head and spreading down to the rest of the body.
• Measles is one of the most contagious diseases in the world. In fact, 9 out of 10 [unvaccinated] people exposed to measles will catch it.
• Children who are vaccinated with MMR develop lasting immunity and protect others. When most of us have immunity to measles, it is less likely to spread.
• Measles makes some children very sick and can even interrupt the immune system’s “memory.” This leaves the immune system less equipped to resist germs it has encountered before. 

Measles Myths: 

• Sometimes it’s hard to know if what’s posted and shared online is true. It can feel confusing, overwhelming, or even alarming. Don’t fall for myths or misconceptions that could hurt your child’s health.
• Can Vitamin A Prevent or Cure Measles? No, vitamin A does not prevent or cure measles, and too much vitamin A can cause serious health problems in children.
• Is too much vitamin A harmful? Yes, large doses of vitamin A can be toxic and make your child sick. If you are pregnant, taking large doses of vitamin A can cause birth defects. 
• Too much vitamin A can cause nausea, vomiting, headache, tiredness, joint and bone pain, blurry vision, skin and hair problems. It can also lead to serious problems like high pressure inside the skull that pushes on the brain, liver damage and coma.
• More and more false claims about children's health topics are spreading through society, including the harmful myth that the MMR vaccine is linked to autism. If you’ve heard this claim or others that have sparked questions or concerns about vaccines, talk with your pediatrician.   
• If you hear something that makes you curious or concerned about your child's vaccines, talk with your pediatrician to make sure you’re getting the facts. Stay curious. Ask questions. Make sure your information comes from people who truly understand the science. 

Staying Healthy During Measles Outbreaks: 

• If you live in an area with an outbreak or plan to travel outside the U.S., your baby can get the vaccine sooner if they are at least 6 months old.  Talk with your child’s pediatrician to learn more. 
   
• If you live in an area with an outbreak, it may be recommended that children who have received their first measles vaccine dose receive their second dose before age 4-6 years. Check with your pediatrician to learn more.
• Infants and children can be contagious [with measles] four days before they show any symptoms. If you think that your child has been exposed to measles, call your pediatrician right away.
• Measles outbreaks are very serious, especially for babies who are too young to be vaccinated. The best way to keep your young baby is to “cocoon.” This means everybody around the baby gets vaccinated, which stops measles from spreading to your baby. 

For Professional Audiences

• Consider measles in any patient presenting with a febrile rash illness, especially if unvaccinated for measles or traveled internationally in the last 21 days.
  
  
• For those reporting measles symptoms, assess the risk of exposure:
  • Are measles cases present in your community?
  • Did the patient spend time out of the country in the 21 days before symptom onset?
  • Has the patient ever received the MMR vaccine?
• Only physicians with immunity to measles should provide care to the patient and family. Standard and airborne precautions should be followed, including:
  • Use of a fit tested NIOSH-approved N95 or higher-level respirator.
  • Use of additional PPE if needed for task (e.g., gloves for blood draws).
  • Cleaning hands before and after seeing the patient.
  • Limiting transport or movement of patients outside of room unless medically necessary.
• If a patient presents with suspected measles: 
  • Provide face masks to patients (2 years of age and older) and family before they enter the facility. Patients unable to wear a mask should be “tented” with a blanket or towel when entering the facility.
  • Immediately move patient and family to an isolated location, ideally an airborne infection isolation room (AIIR) if available. If unavailable, use a private room with the door closed.
  • No other children should accompany a child with suspected measles. Patients (2 years of age and older) and family should leave face masks on if feasible. 
• To ensure rapid investigation and testing with contact tracing, Public Health notification should occur immediately upon suspicion of measles.
  • Acute care facilities should immediately notify the hospital epidemiologist or infection prevention department.
  • Outpatient settings should immediately notify local or state health departments.
• Who is at highest risk of acquiring measles infection?
  • Unvaccinated children or adults
  • Incompletely vaccinated (<2 doses of MMR) children or adults
  • Individuals with known exposure to measles or recent travel to areas with active measles transmission
• Who is at highest risk of severe measles infection or complications of measles?
  • Infants and children aged less than 5 years
  • Adults aged more than 20 years
  • Pregnant women
  • People with compromised immune systems, such as from cancer, chemotherapy, or HIV infection
• Measles can cause serious illness, even in previously healthy children. Complications of measles can include:
  • Ear infections
  • Diarrhea
  • Pneumonia (either from measles virus itself or from bacterial superinfection)
  • Encephalitis
  • Death
  • In addition, measles infection increases the risk of other severe infections for months or years after measles through the mechanism of immune amnesia.
• Suspect measles? 
  • Airborne precautions are needed whenever there is any suspicion of measles exposure.
  • Promptly isolate, collect specimens, and report patients with suspected measles to public health.
• Vaccination is the cornerstone of measles prevention. During an outbreak, MMR vaccine should be offered to all eligible people with known exposure or in the outbreak community who lack evidence of measles immunity.
  
  
• Measles often starts with a fever, cough, runny nose, and red eyes, before those infected develop a maculopapular rash that begins on the face and spreads down towards the body. The incubation period between exposure and initial symptoms is approximately 8-12 days.
  
  
• Vitamin A does not prevent measles. Only the MMR vaccine can prevent measles. Vitamin A should not be used to try to prevent measles, nor should it be used in high dosages as it can lead to toxicity. 
  
  
• Vitamin A does not prevent measles. It is recommended for those infected with measles, regardless of hospitalization status. Recommended administration once daily for 2 days (ie, immediately on diagnosis and repeated the next day).
  
  
• Vaccination is the most effective way to prevent measles. A dose of measles vaccine administered after 12 months of age results in immunity in 93% of people. The 2nd dose increases immunity to 97%.
  
  
• During an outbreak of measles in a healthcare facility, or in healthcare facilities serving a measles outbreak area, two doses of MMR vaccine are recommended for healthcare personnel, regardless of birth year, who lack other presumptive evidence of measles immunity.
  
  
• Measles in healthcare providers has contributed to the spread of measles during outbreaks. Evidence of immunity to measles should be required for healthcare providers. 
  
  
• Vaccination is the cornerstone of measles prevention. During a community-wide outbreak that affects infants, MMR vaccine has been shown to be effective in preventing symptoms after exposure and may be recommended for infants 6 through 11 months of age.